Healthcare Provider Details

I. General information

NPI: 1427758234
Provider Name (Legal Business Name): TRACY ALLISON SNYDER LSW, MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TRACY ALLISON HOLSTEIN

II. Dates (important events)

Enumeration Date: 03/09/2023
Last Update Date: 03/09/2023
Certification Date: 03/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 SHOEMAKER DR
LOVELAND OH
45140-7784
US

IV. Provider business mailing address

124 SHOEMAKER DR
LOVELAND OH
45140-7784
US

V. Phone/Fax

Practice location:
  • Phone: 513-404-1800
  • Fax:
Mailing address:
  • Phone: 513-404-1800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.0600711
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: